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ITEM TWO <br />Schedule Of Coverages And Covered Autos <br />This policy provides only those coverages where a charge is shown in the premium column below. Each of these <br />coverages will apply only to those "autos" shown as covered "autos". "Autos" are shown as covered "autos" <br />for a particular coverage by the entry of one or more of the symbols from the Covered Autos Section of <br />the Business Auto Coverage Form next to the name of the coverage. <br />Covered <br />Coverages <br />Autos <br />Limit <br />Premium <br />Liability <br />07 <br />$ 100,000 CSL <br />$ 1,560.00 <br />Personal Injury <br />Separately Stated In Each Personal Injury <br />$ <br />Protection <br />Protection Endorsement Minus <br />(Or Equivalent <br />$ Deductible <br />No-fault Coverage) <br />Added Personal <br />Separately Stated In Each Added Personal <br />$ <br />Injury Protection <br />Injury Protection <br />(Or Equivalent <br />Endorsement <br />Added <br />No-fault Coverage) <br />Property Protection <br />Separately Stated In The Property <br />$ <br />Insurance <br />Protection Insurance Endorsement Minus <br />(Michigan Only) <br />$ Deductible <br />For Each Accident <br />Auto Medical <br />07 <br />$ 5,000 <br />$ 174.00 <br />Payments <br />Medical Expense <br />Separately Stated In The Medical Expense <br />$ <br />And Income Loss <br />And Income Loss Benefits Endorsement <br />Benefits (Virginia <br />Only) <br />Uninsured <br />07 <br />$ 100,000 CSL <br />$ 99.00 <br />Motorists <br />Underinsured <br />07 <br />$ 100,000 CSL <br />$ INCL <br />Motorists <br />(When Not Included <br />In Uninsured <br />Motorists Coverage) <br />Page 2 of 13 © Insurance Services Office, Inc., 2009 <br />oR,N F RiskMougementDMslcrn <br />a� REVIEWED & APPROVED BY. <br />`® tq {iceva�o <br />Risk Management Specialist <br />CA DS 03 03 10 0 <br />